Controlling the Ebola outbreak in West Africa will cost at least $600 million and could take up to 9 more months, U.N. officials said.

Controlling the Ebola outbreak in West Africa will cost at least $600 million and could take up to 9 more months, United Nations officials said.

The response to the outbreak needs to be scaled up by a factor of three or four before the epidemic can be slowed and stopped, according to David Nabarro, MD, the U.N.'s senior coordinator for the crisis.

That will cost "at least $600 million and it may be a lot more," Nabarro told reporters in New York City, where he and colleagues are briefing the U.N. on a recent visit to the region and conferring with U.S. government agencies.

The World Health Organization (WHO) said the epidemic is speeding up, with more than 40% of the 3,069 cases in the 10-month old outbreak recorded in recent weeks.

The current goal, according to WHO Director-General Margaret Chan, MD, is to "reverse the trend" within the next 3 months.

But as money and technical expertise comes in, she said, "we would like to stop transmission in 6 to 9 months" in Guinea, Liberia, and Sierra Leone, the countries hardest hit by the epidemic.

Nabarro said the U.N. has a 12-point plan to ramp up the response, which includes improvements in patient care, better communication with the public in the three nations, providing food and other necessities to people in regions where transmission is intense, and more material aid as well as cash to pay salaries for healthcare workers.

A key element is overcoming obstacles to travel to the region, he said, noting that ships are not docking and many airlines have cancelled flights in and out.

Indeed, he and Keiji Fukuda, MD, the WHO's assistant director-general for health security, themselves had difficulty getting and in out of the region during a visit late last month, reporters were told.

Airlines are not cancelling flights because of fear of Ebola, Chan said. Instead, they worry that the crisis means ordinary healthcare for aircrews would not be available in the event of accident or other illness.

But the effect of that is to hamper the relief effort: WHO is mobilizing international experts in infection control and clinical care, Chan said, "but we are not able to deploy them."

Exactly what is needed is a moving target, Fukuda said. "There's no static number," he said, "as the outbreak grows, more people and materials are needed to work on it."

But he said experience has shown it takes between 200 and 250 people to care for 80 Ebola patients, including front-line clinical care and support workers.

"We would estimate there is going to be the need for several thousand people taking care of patients," Fukuda said, as well as several hundred international workers to run labs, care for patients, and train other workers.

Fukuda noted that much of the transmission in the three countries happens as people care for ill family members because of "a lack of capacity in many different ways -- there aren't enough beds for people to go to if they are ill; there are not enough ambulances to transport people if they're ill."

Many patients, he said, are reluctant to be identified as having Ebola "because there are no real benefits ... for many of them."

Meanwhile, the WHO says a cluster of three confirmed cases in Port Harcourt, Nigeria, is related to the country's first cases in Lagos and illustrates "multiple high-risk opportunities for transmission."

Nigeria's earliest cases were contacts of a man who flew from Liberia to Lagos on July 20 and died there of Ebola 5 days later. One of his contacts, who was under quarantine, fled to Port Harcourt for treatment.

The doctor, who treated the man from Aug. 1 to Aug. 3, became the index case in Port Harcourt's cluster, the agency said.

After he developed symptoms, the doctor continued to treat patients at his private clinic and operated on at least two. When the symptoms worsened Aug. 13, he stayed home until he was hospitalized Aug. 16. He died Aug. 22.

Before his hospital admission, he had many other contacts, including relatives and friends who visited to celebrate the birth of a baby.

Aside from the doctor, the other confirmed cases in the cluster are his wife and a patient in the hospital where he was treated, but health workers are monitoring more than 200 contacts, including 60 who are considered to have had "high-risk or very high-risk exposure," the agency said.

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